Influence of psychological factors on the response to clomipramine in hospitalized chronic low back pain patients. Preliminary data from a psychometric study.
BACKGROUND
Chronic low back pain is a complex condition produced by multiple factors. Psychological disturbances have been found in previous studies using a variety of psychological tests. The most widely used self-administered questionnaire was the Minnesota Multiphasic Personality Inventory (MMPI).


OBJECTIVE
To assess the response to clomipramine in chronic low back pain patients according to baseline MMPI scores.


METHODS
Thirty chronic low back pain patients were given clomipramine intravenously during a ten-day hospital stay, then orally for 20 days. The dose was gradually brought up to 150 mg/d. The MMPI was administered on the day before treatment initiation. MMPI scores were not looked at until the end of the study. The Saint Antoine Questionnaire, a visual analog scale for pain, Schöber's maneuver, and the global result as assessed by the patients (success or failure) were evaluated on days 0 (D0), 4 (D4), 10 (D10), and 30 (D30).


RESULTS
The initial mean MMPI scores for hypochondria, depression, and hysteria were significantly lower in the 23 patients (76%) who considered their treatment successful on D30. Among the 13 patients with high hypochondria and hysteria scores, five improved during hospitalization then had a relapse after returning home.


CONCLUSIONS
The response to treatment with clomipramine was better in nondepressive patients. The hypochondria and hysteria scores were the best predictors of the response to clomipramine. These results may provide a basis for selecting those chronic low back pain patients most likely to benefit from clomipramine therapy.
Fouquet
B
B
Department of Physical Medicine, CHU, Hôpital Trousseau, Tours, France.
Goupille
P
P
Jeannou
J
J
Etienne
T
T
Chalumeau
F
F
Valat
J P
JP
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D002908:Chronic Disease; D002997:Clomipramine / Q000627:therapeutic use*; D005260:Female; D006760:Hospitalization; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000523:psychology*; D008950:MMPI; D008297:Male; D011795:Surveys and Questionnaires
D000929:Antidepressive Agents, Tricyclic; D002997:Clomipramine